Dr. Bob’s Book Reviews
Wisdom Madness and Folly
by R.D. Laing
McGraw Hill, NY, NY, 1985.
R. D. Laing was an English psychiatrist, a very thoughtful, observant physician. Different than his colleagues, he did not swallow whole the tablets of orthodoxy which he and his fellows were fed and expected to regurgitate unthinkingly. Like few others in the medical professions, he gradually came to the conclusion that “psychiatry has been oversold.”
Wisdom, Madness and Folly is Laing’s story, briefly told, of his early life, studies and passage into the profession of psychiatry. Like the reviewer, he came to recognize that schools which claim to promote thinking and imagination often create opposing environments. “A medical institution is not the place to find freedom of thought and speech.”
Thus, he struggled to find truth and sanity amidst crazy patients and systems run by a relatively insane psychiatry. More than fear the lunatics he attended, Laing became anxious with his psychiatrist peers. “I am still more frightened by the fearless power in the eyes of my fellow psychiatrists than by the powerless fear in the eyes of their patients.”
His fears were, and still are, spot-on for four broad reasons:
1) Society and consumer demand have placed great powers in the hands of the psychiatric profession. To lock people up for long periods and treat them with much less ado than the legal system puts criminals behind bars.
2) Psychiatrists treat patients with remedies which are sometimes just as crude and barbaric as ones used in bygone centuries: “drugs, straitjackets, padded cells, tube feeds, injections, electroshocks, comas, lobotomies …”
3) Psychiatric methods have never been studied or tested in any scientific manner to show them to be valid, safe or useful.
4) Psychiatrists wield great power but have little Real Knowledge of human behavior, problems, and possibilities. “The psychiatrist is condemned to know next to nothing of what he is putting a stop to.”
Laing’s ultimate conclusion seems to be that human beings need to be treated as human beings. That human relationships were and are more important than psychiatric diagnoses. Laing gives a number of touching examples of humanity at work in the treatment of mental illness. At the same time, he shares a number of frightening vignettes suggesting the lack thereof which surely persist into present time.
Toward the end of Wisdom, Madness and Folly, Laing tells of giving a seminar to senior staff of a psychiatric unit in a London hospital. “After I had talked for a while about how psychiatric diagnosis can affect our relations with the patient, the chief psychiatric social worker asked if she could put a question to me.
“‘Dr. Laing, I am told that you allow your schizophrenic patients to talk to you.’
“‘Yes, I do,’ I replied.
“You could have heard a pin drop –– but not a pin dropped.”
Laing’s book is a quick read with limited medical jargon. It is not for the light-headed, but has the potential to stir the reader to think and ponder, and maybe even wonder. Psychiatry has changed little in 35 years.
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The Myth of Psychotherapy
by Thomas Szasz
Anchor Press, Garden City, NY, 1978.
Thomas Szasz (1920-2012) was a physician, professor of psychiatry, and writer widely known as a keen opponent of involuntary hospitalization and psychiatric treatment of the mentally ill. He did practice psychiatry and and was open to psychotherapy with consenting adults. The Myth of Psychotherapy is one of several books written protesting that “the concept of mental illness constitutes an ideology of intolerance, with belief in mental illness and the persecution of mental having replaced belief in witchcraft and the persecution of witches.” The present book follows up the basic premise of his second which exposes The Myth of Mental Illness.
Szasz rarely minces his words as he discusses the Problem, Precursors, Paradigm, and Politics of Psychotherapy in this book. His general premises are as follows:
• psychiatry is not based on science and provides “metaphorical” rather than literal or real treatment.
• psychiatrists treat non-diseases, commonly against the will of patients and thus commit torture.
• fakery, fraudulence, and pretension lie as much in treatment of mental illness as in its causes.
• almost any form of treatment passes in psychiatry as therapeutic – the possibilities appearing to be boundless.
• that many psychotherapeutic procedures are actually harmful to patients.
• that the mythology of psychotherapy conceals deceptions as well as coercion by and from providers, politicians, judges and the general public.
Szasz’s basic message comes down to the fact that psychiatry is a fabrication of medicine and society to deal with human beings who are not mentally acceptable. Pseudo-science guides psychiatry and people accept the results unthinkingly. Psychiatrists mistreat people with healthy brains who are really in need of “healing of the soul.” They take on problems which in other times and places are more properly handed to priests and pastors, sages and saints.
Psychiatry has become the “state-accredited therapeutic church” which medicalizes spiritual ills with supposed remedies of constraint, electricity, and chemistry. “Surely, works of piety and love, self-discipline and honest labor, are still infinitely better cures for what ails the human soul than medicine, mechanized psychotherapies, and mental health centers.”
In the second part of his book, Szasz reviewed the works of early practitioners in the field of mental illness and health. He takes a quite dim view of Freud, but seems relatively sympathetic to Jung. That because he believed that religions are “systems of healing for psychic illness…. That is why patients force the psychotherapist into the role of a priest …”
Overall, Thomas Szasz takes medicine and politics to task for how they handle mental illness with hospitalization and imprisonment, repression and repression. Still, he realizes that governments the world over have been laden with the obligation of preservation and promotion of health.
But, few would have been happier if those powers had decided to Abolish Psychotherapy. Szasz stands like R.D. Laing in general belief that “psychiatry has been oversold.”
Were they with us today, they might want to consider a broader perspective and proclaim that “medicine has been oversold.”
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